Periodontal health of endodontically treated molars restored with composite CAD/CAM endocrowns versus stainless steel crowns in Egyptian children: a randomized controlled trial.

BACKGROUND: Subgingival crown margins have been linked to chronic gingival inflammation in pediatric patients. This clinical trial evaluated periodontal outcomes in first permanent molars that had undergone root canal therapy and were subsequently restored with either CAD/CAM Composite Endocrowns or stainless steel crowns (SSC). PATIENTS AND METHODS: Twenty-four children aged 10–13 years diagnosed with extensive caries in their first permanent molars were recruited from the Pediatric Dentistry clinics at the Faculty of Dentistry, Cairo University. Participants were randomly allocated to one of two treatment arms, where they received either a CAD/CAM Composite Endocrown or an SSC. The primary outcome was periodontal health assessed by Probing Pocket Depth (PPD). Secondary outcomes included Gingival Index (GI), Plaque Index (PI), and radiographic healing evaluated using the Periapical Index (PAI). Clinical parameters were recorded at baseline and at 1 week, 3, 6, 9, and 12 months. Statistical analysis was performed using appropriate parametric and non-parametric tests with a significance level set at p ≤ 0.05. RESULTS: At baseline, both groups were comparable in age, gender, and all clinical indices (p > 0.05). During follow-up, mean PPD values were significantly lower in the Endocrown Group than in the SSC Group at all time points (p < 0.001). GI values were significantly lower for Endocrowns at 1 week and 6 months (p = 0.031 and 0.004, respectively). PI values showed no significant intergroup difference (p > 0.05), though both groups improved over time. Radiographically, both groups demonstrated favorable periapical healing with no significant differences in PAI scores after 12 months. Inter- and intra-observer reliability was excellent (ICC > 0.8). CONCLUSION: Within the 12-month follow-up period, composite CAD/CAM Endocrowns were associated with significantly reduced probing pocket depth and healthier gingival conditions compared with SSCs, which suggests that CAD/CAM Endocrowns offer a biologically conservative interim restoration for molars treated endodontically in pediatric patients. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT05250609. Registered 22 February 2022. Retrospective registration. https://clinicaltrials.gov/study/NCT05250609.